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Benefits". 
b.  VA Form 10-10T  Application for Medical  Benefits.
c.  VA Form 10-101(R)  Insurance Information.  (Be  aware that when you provide the VA with insurance  information, they may bill your insurance despite the  possibility or proof that your condition is service  connected.) 
d.  VA Form 10-10F(RS)  Financial Worksheet.

3.  Go to the Eligibility Office at the nearest VA Medical Center.  Have the following information prepared:

a.  All VA Forms mentioned above.
b.  Proof of Identification.
c.  DD214 and addendum DD215 if applicable.
d.  Written history of health problems and why you  think they are service connected.

4.  Set up Persian Gulf Registry Exam.

5.  Set up Persian Gulf Registry Exam for your Spouse and Children.

6.  Request you be assigned a Primary Care Doctor.  Research which Doctors are experienced and good at your local VAMC by consulting with other Persian Gulf and Vietnam veterans, and specifically request those doctors.

7.  Set up Follow-up Medical Exams with your assigned doctor.

8.  In addition to medical services, social services and mental health services are available at your local VAMC. Request appointments as needed.

9.  In the event you have a complaint regarding VA service or care,  fill out VA Form VA-95.  Make a copy and file the original with the Chief Administrative Officer at the VAMC where you recieved service.  Ask for a dated receipt when you file this form, as they have a history of getting lost.  If, after one month, you receive no reply, or no investigation is taking place, contact you local member of Congress and file a Congressional Inquiry.  Include all copies of VA-95 forms and correspondence.

Medical Exam Protocol

Phase I
Phase I should consist of a comprehensive history and medical evaluation with completion of Phase I questionnaires.  The exam, both in content and quality, should parallel an in-patient admission work-up.  The exam should include a complete medical history including: family, occupational, social (including tobacco, alcohol and drug use), exposure to possible toxic agents, psychosocial condition and review of symptoms.  A comprehensive medical evaluation, with focused attention to the patients symptoms and health concerns, should be conducted.  Laboratory tests should include a CBC, urinalysis and SMA-12.

Individuals who, after completing a Phase I evaluation, do not have a clearly defined diagnosis which explains all their symptoms should be reviewed by their physician for further evaluation and consultations needed and/or for referral to one of the four Regional Medical Centers for Phase II.

Phase II
Phase II evaluations consist of the following laboratory tests, consultations, and as necessary, symptoms-specific examinations.  Laborary tests should include:  CBC, Sed rate (ESR), C-Reactive protein, Rheumatoid factor, ANA, Liver function, CPK, Urinalysis, TB skin test (PPD) with controls, Chest X-ray, Hepatitis serology, HIV testing, VDRL, B12 and folate, Thyroid function tests.

Consults:

• Dental: Dental only if participant's annual screening not done


• Infectious Disease


• Psychiatry:  With physician-administered instruments:

• Neuropsychological Testing: Only as indicated by psychiatry consult

• Diarrhea:  GI consult; Stool for O & P; Stool Leukocytes; Stool culture; stool volume; Colonscopy with biopsies; EGD with biopsies and aspiration.


• Abdominal:  GI consult; EGD with biopsy/aspiration; Colonscopy with biopsy; Abdominal ultrasound; UGI series with small bowel FT; Abdominal CT scan.


• Headache:  MRI-head, LP (glucose protein, cell count, VDRL, oligoclonal myelin, basic protein, pressure); Neuro consult.


• Muscle Aches / Numbness:  EMG/NCV.


• Chronic Fatigue:  Polysomnography and MSLT.


• Chronic Cough / SOB:  Pulmonary consult; Pulmonary function; Tests with excercise and ABG; Methacholine challenge; If PFTs are normal, consider bronchoscopy with biopsy/lavage.


• Memory Loss (Only if verified by psych evaluation):  MRI-head; Lumbar puncture; Neuro consult; Neuro-psych testing.


• Chest Pain / Palpitations:  ECG; Exercise stress test; Holter monitor.


• Reproductive Concerns:  Urology consult; GYN consult.


• Vertigo / Tinnitus: Audiogram; ENG; BAER.


• Skin Rash:  Dermatology consult; Consider biopsy.

Research

The VA has two major epidemiological studies in progress.

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Second Edition - Fall 1997          Page 12